Knowing our patients: a cross-sectional study of adult patients attending an urban Aboriginal and Torres Strait Islander primary healthcare service
Deborah A. Askew A B E , Warren J. Jennings A B , Noel E. Hayman B C , Philip J. Schluter D A and Geoffrey K. Spurling A BA The University of Queensland, School of Clinical Medicine, Primary Care Clinical Unit, Level 8, Health Sciences Building, Building 16/910, Royal Brisbane & Women’s Hospital, Herston, Qld 4029, Australia.
B Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, 37 Wirraway Parade, Inala, Qld 4077, Australia.
C The University of Queensland, School of Clinical Medicine, Royal Brisbane & Women’s Hospital, Herston, Qld 4029, Australia.
D University of Canterbury – Te Whare Wānanga o Waitaha, School of Health Sciences, Private Bag 4800, Christchurch 8140, New Zealand.
E Corresponding author. Email: d.askew@uq.edu.au
Australian Journal of Primary Health 25(5) 449-456 https://doi.org/10.1071/PY18090
Submitted: 14 June 2018 Accepted: 01 October 2018 Published: 20 December 2018
Abstract
Many Aboriginal and Torres Strait Islander people live in urban areas, but epidemiological data about their health status and health needs are lacking. This knowledge is critical to informing and evaluating initiatives to improve service delivery and health outcomes. One potential data source is de-identified routinely collected clinical data. This cross-sectional study, conducted in an urban Aboriginal and Torres Strait Islander primary healthcare service, involved randomly selecting a sample of 400 patients aged ≥15 years, and manually extracting electronic health record data. In the sample, 49% of patients were aged <35 years, 56% were female and 38% were employed. Overall, 56% of females and 47% of males aged 35–54 years had depression, 26% had experienced a bereavement within the last 12 months, and while 44% were alcohol abstainers, 35% were drinking at high-risk levels. The present study cannot demonstrate causal relationships between the observed high rates of chronic disease in older people and frequent experiences of bereavement and high levels of mental ill health in young- and middle-aged adults. However, a life course approach provides a framework to understand the interconnectedness of these results, and suggests that strategies to blunt the intergenerational burden of chronic disease need to address the social and emotional wellbeing of youth.
Additional keywords: chronic disease, descriptive epidemiology, mental ill-health, self-medication, social and emotional wellbeing, social determinants of health.
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